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  • November 05, 2017 1:12 PM | Anonymous member (Administrator)

    While following all related news and comparing our current position to similar times in the recent past, I remain 95% confident that the plans in place will produce adopted legislation that will increase Medicare payments for non-contracted providers on January 1, 2018, followed closely by CURES-like payments for all claims processed in 2017.

    One of the ways we could get HR4229 passed is by hooking it to a CR (continuing resolution), which is looking more and more likely. From The Hill:

    "Both chambers take a recess the week of Thanksgiving, further squeezing the legislative timeline.  

    When lawmakers return, they will have just two weeks until the Dec. 8 deadline, which has sparked some talk of passing a continuing resolution (CR), a stopgap measure that keeps government funding unchanged. Republican leadership is even considering pushing the whole debate into February, a last resort that Democrats oppose." Read more...

  • October 04, 2017 9:55 AM | Anonymous member (Administrator)

    It's interesting that a thoughtful piece on the reasons why the Federal government can't get anything done is topped with a picture of Senate candidate Roy Moore. And I can't find any flaw in the author's reasoning.

    Read the piece and see what you think.

  • August 28, 2017 4:08 PM | Anonymous member (Administrator)

    ADMEA was incorporated as a 501 (c) (6) organization, a non-profit trade association, and not a 501 (c) (3), specifically to avoid situations like this:

    "The Foundation for Moral Law, a nonprofit run by Kayla Moore -- the wife of U.S. Senate candidate Roy Moore -- may be violating its tax-exempt status by posting Moore's campaign ads and articles about Moore's campaign, according to attorneys who specialize in nonprofit tax law who spoke to

    Tax-exempt 501(c)(3) organizations like the foundation, whose activity largely comprises filing religious liberty lawsuits, are barred from engaging in political activity and could lose their tax-exempt status if the IRS determines they did so.

    The organization's Facebook page shared an endorsement of Moore by evangelical personality Dr. James Dobson and has shared links to a number of articles on the race, including Roy Moore's campaign announcement and an editorial criticizing the Senate Republicans' campaign arm for treating Sen. Luther Strange as an incumbent. The video was later removed from the foundation's Facebook page." (Read more...)

    Roy Moore is an embarrassment to both Christianity and the State of Alabama. Politicians who don't believe in the rule of law should find another occupation!

  • August 15, 2017 2:05 PM | Anonymous member (Administrator)

    While I just don't see how we can declare health care a "right" without creating slaves to provide it, any more than we can food, clothing, shelter or anything else one can't live without, we are still discussing the wrong issue.

    This POLITICO article indicates yet another scare concerning the subsidies paid to insurers to prop up the ACA Exchanges. The lack of certainty is one reasons insurance companies give for raising premiums on policies that are already next to useless because the deductibles are so high.

    When are we going to address the problem of making actual health care available, rather than arguing about how to make insurance available!?!

  • August 04, 2017 10:10 AM | Anonymous member (Administrator)

    Who knows what will happen next in the mess that claims to be an attempt to improve our health care delivery system? We must hope for one of two things to happen—either Congress must move on to something else, maybe tax reform—or some compromise must be reached that will allow passing something, so members can claim victory and move on. Every time I think one or the other is happening, some news article pops up suggesting otherwise.

    While I would love for this to get out of the way, allowing Sec. Price to focus more time, energy and attention to solving some of our issues, the fact that a legislative cure is underway has shifted my primary concern to another aspect of this battle.

    How on earth did we allow ObamaCare to lull us into believing that everyone in the country deserves free health care whenever they ask for it, with no concern, apparently,  over the undeniable fact that someone else must pay for it—either taxpayers, or providers, who can't get fair reimbursement for their services?

    No one can live without food. Why, if healthcare is a right, don't we consider food to be a right as well. And shelter, and clothing, and all the other things that folks can't live without? Looked at this way, free, unlimited health care is ridiculous.

    Now, I certainly believe in charity, but that is—or at least should be—the purview of churches, synagogues, temples, and the many charitable organizations that exist for that purpose. Where does it say that the way to bestow charity is to force others to pay for it by having it delivered by the government? The government should stay out of the way of those delivering charity, and recognize economic inequality in law and regulation, but not be the sole provider of everything one needs to live!

    I still insist that the single greatest improvement we could make to achieve the goal of more affordable, available health insurance would be through changes in the tax rules and insurance laws that would move the selection—and tax deductions—for health insurance from employers and the government to the individual. We should buy health insurance the same way we buy homeowners and automobile insurance, making our own choices about deductibles, co-pays and coverage. Force insurance companies to compete for quality and cost, allow consumers to choose, and you will be amazed at how costs drop.

    Currently, the US has the most expensive health costs in the world, and is about 17th in quality. With a government enforced re-insurance pool for  high risk patients, rewards for living a healthier life style, and premium subsidies for the indigent, we could meet almost everyone's objectives of making affordable insurance available to everyone.

    Of course, there are many unstated details that must be included, but you wouldn't read about them if I tried to explain.  If you are really interested in the subject, start by reading this article, which was referred to in my last post. The Swiss have figured out how to do it right, and we could easily adapt their system to work for us.

  • May 10, 2017 10:20 AM | Anonymous member (Administrator)

    Personally, I prefer to make my own decisions. I am still angry that Medicare prevented me for keeping the excellent BCBSAL policy I had in force when I reached the age of 65. Instead, I got a letter from Blue Cross about two months before my birthday telling me that if I expected to have health insurance after the first day of my birth month I had better be signing up for Medicare now! (And by the way, we have this great supplemental policy we'd like to sell you...)

    Many years ago, I had the privilege of hearing Princeton economics professor Dr. Uwe Reinhardt speak about the evolution of American health care, and he made more sense than anyone I have heard or read before or since. He is a widely recognized expert on health economics and is very familiar with the systems in other countries.

    More recently, while reading an editorial by Steve Forbes of Forbes Magazine, I followed a link to an excellent article that referred to Dr. Reinhardt's expressed opinions on possible solutions to the dilemma we face in this country. I urge you to follow the link when you have at least 15-20 minutes available, so you can watch the video of Harvard Business School's Regina Herzlinger. It's ten minutes excerpted from a speech that surely last thirty or more minutes, and it is both informative and absolutely hilarious!

    The author, Dr. Reinhardt and the Harvard professor all agree that we should take a closer look at the Swiss system. It fixes another issue that has always bothered me; many of you young folks may not know that employer-paid health insurance was created as a loophole in WWII wage freezes to allow poaching employees. I don't like employers choosing my insurance plan any more than the government.

    The Swiss require that health insurance be sold like homeowners and automobile insurance, with choices left up to the purchaser. Their system subsidizes the poor, covers previously existing conditions, provides for the availability of widely varying benefit packages, and could be easily adapted to adjust for differences in the US economy.

    It seems to me that adopting a modified version of the Swiss system would address address every concern expressed by all effective entities. It would certainly be a vast improvement over ObamaCare, RyanCare & TrumpCare!

    Bookmark this link, and after you read the article and watch the video, let me know what you think.

  • May 08, 2017 9:48 AM | Anonymous member (Administrator)

    While the Republicans got a bill through the House with many of the same tactics they deplored when ObamaCare was passed, and we still don't know much about the content, what is clear is that we are going back to the old-fashioned way of passing a bill that seems to have fallen out of fashion.

    The House bill has gone to the Senate, where it will be either modified or replaced, followed by a conference committee comprising members from both sides of the aisle and both houses that are very familiar with the issue. This committee will, presumably, produce a single bill that must be approved by both House and Senate before going to the President for the signature that will make it a law.

    In this process, only one thing is currently clear—nothing will come of it quickly. It will likely take many months, so there is no reason for anyone to panic over the possible affect of included changes.

    It is also clear from the content of the debate over the House version that our little industry is still far from a priority for addressing issues that affect health care. We still have to go make our case—that we can contribute considerable value to the healthcare continuum if treated fairly. We are in a much better position to do that than ever before, and I am confident that we will be successful, but it will take some time to accomplish. You just have to figure out ways to survive until we succeed.

    The assault on our industry has had many casualties, but we also have many members, in and out of competitive bid areas, who have successfully made changes allowing them to do very well in the current market.

    And it is still true that the market is growing at a huge rate that will continue for many years. The demand will be there, and someone will meet it. Why not you?

  • March 12, 2017 1:21 PM | Anonymous member (Administrator)

    The mind-boggling debate over "repealing and replacing" the ACA continues to confuse the terms "health care" and "health insurance."

    Whether it's the panelists on Meet the News or HHS Sec. Price, everyone seems to use the terms almost interchangeably, when they actually refer to totally different issues.

    One of the major problems with ObamaCare is the high deductibles on many, if not most, health exchange policies that often prevent folks who clearly have insurance from getting the actual care they need. 

    No one is addressing either the lack of properly distributed physicians and other health care providers that prevents many rural residents from having reasonable, attainable access to the care covered by their insurance, or the existence of incentives and disincentives that affect the care provided by those already in place. Most everyone describes the changes they are promoting as "improving quality while lowering costs" when the far more likely results of those changes would be to ration care.

    In my experience, the quality of care provided in many cases is affected most by the patient's and family member's knowledge and persistence in participating in the decisions made about tests and treatments, or the simple failure, for whatever reason, to follow the orders of providers. Neither of those issues is addressed by changing how insurance coverage is accessed or what it costs.

    As I have often insisted, words have meanings, and if we can't properly frame the debate with a clear understanding of whether we are discussing the availability of insurance coverage or the availability of actual health care, then we are never going to solve the problems of a health care delivery system that is not working very well for many people.

  • February 23, 2017 9:17 AM | Anonymous member (Administrator)

    I am convinced beyond any doubt that the HME industry hit rock bottom in 2016 and has begun a move that will bring us as close as we will ever get to the marvelous first ten years of existence. We have never had an HHS Secretary who knows and appreciates our industry like Dr. Tom Price, and all I have heard about the prospective CMS Administrator has been good. The changes CMS has already made or proposed have been encouraging.


    Many experts believe that competitive bidding is too entrenched to be replaced right away and steps have been taken to define a clear path for improvements to make it acceptable. If that is what happens, the industry can recover and grow, but I believe it is still possible–even likely–that Dr. Price will find a way to implement the Market Pricing Plan (MPP). CMS has adopted parts of that plan and proposed other changes taken directly from the legislation Dr. Price has introduced. The legislation that allowed the creation of the current “competitive acquisition” program should allow the adoption of the MPP via the creation of new regulations.


    Here’s what I believe will happen:


    • Secretary Price will freeze rates at January 2016 levels to mitigate further limitations on access and harm to providers.
    • He will direct the CMS Administrator to cause the creation of new regulations that incorporate the principles of the MPP, which will require 60 to 90 days to complete.
    • The proposed rule will be published for notice and comment, which requires another 60 days.
    • Reviewing and responding to the comments will require approximately another 30 days.
    • The new rule creating the MPP will be published with an effective date 60 days from the date of publication.
    • During this process, the CBIC will have been busy vetting prospective bidders and preparing to accept bids under the revised system.
    • The new process will be in place on October 1, 2017, in time to be used to create the fee schedule effective January 1, 2108.


    Of course, this is an optimistic view, but also one that can be accomplished if providers continue doing the things that need to be done.


    On my first lobbying visits to Washington in 1975, when we introduced ourselves to Congressional staff, the reaction was usually “Oh, you’re one of those rip-off artists!” On recent visits, we have been greeted with respect as part of the solution to ever-increasing health care costs.


    That turnaround in our image hasn’t been produced by getting rid of all the bad apples, because the government has remained unwilling to do what the industry has told them was necessary to accomplish that lofty goal.


    It has happened because of a lot of hard work, by a lot of volunteers, and the creation and support of organizations with the expertise needed for such accomplishments.


    It has happened because providers have supported Medtrade, gaining information unavailable elsewhere to keep up with the products and services that allow operating successful, efficient businesses.


    It has happened because providers have supported AAHomecare, an organization that has served so very well as the industry’s voice in Washington, and the member services organizations who have trained and supported providers in so many ways, including the process of grassroots lobbying.


    It has happened because providers have supported the local trade associations who have dealt with local issues so effectively and provided the coordination to make grassroots lobbying timely and effective.


    The potential for our industry has never been as great. If you want to be a viable part of a dynamic, growing and exciting industry that does well by doing good, go to Medtrade and learn how to be a better and more efficient businessperson with an appropriate product line for your chosen market. Join and support AAHomecare, your local association and one or more member service organizations. Get or stay involved with your Representative and both Senators. And always be willing to give your own time and money to improving the overall health of the industry.


    HME is a great place to be today!

  • November 19, 2015 10:34 AM | Anonymous member (Administrator)

    Every week we get several calls focused on the same two variations on a theme: we don't have nearly enough ATPs in Alabama, and; patients are often harmed by well meaning but misinformed providers.

    Apparently, the need for relatively complicated wheelchairs far exceeds the number of properly trained people to spec and fit them in a manner that actually meets the patient's needs without exposing them to harm.

    Calls in the first category are divided between those who brag on the number of chairs they are placing and those who have questions about meeting the requirements for licensure in Alabama, so they can provide those needed services.

    Calls in the second category decry the harm a patient suffered because they were placed in the wrong or poorly fitted chair because the provider didn't know any better.

    Now, I'm don't mean to get off on a rant here...I'm not promoting anything (except better patient care), but I hate to think that current Alabama providers can't meet the demand, or even worse, provide products without the trained staff required to do it properly.

    And I'm not suggesting anything except that all members need to examine where you stand on this issue and make proper adjustments to protect or improve your business. Regardless of anything we might do, there is enormous pressure to expand the requirements for credentials, so if you are fitting any kind of wheelchair, you need to recognize the risks and opportunities you face because of the level of staff training.

    Surely you don't want to risk harming a patient, and that's reason enough for more training, but do you know how much additional business is sure to be available if your staff can recognize all the needs of a chair user, and meet them? Do you have a clue how much harm it does to your company's reputation when referral sources even think you misfit or chose the wrong chair for a patient? Do you see the risk of increased competition in your market if you don't have credentialed staff in this arena?

    Things are going to change, and if you expect to stay in the mobility business, you need to be training your involved staff and getting them credentialed. Don't get caught out in the cold when new competition arrives or the requirements for an ATP are greatly expanded!

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